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Session Guide

Effective Public Education

EFFECTIVE PUBLIC EDUCATION SESSION GUIDE

Effective Public EducationSESSION GUIDE

PURPOSE AND CONTENT

While prescribers play an essential role in the choice of medicines, the role of the consumer (the patient) is equally important. Public knowledge, attitudes and perceptions regarding the use of medicines influence the decision to seek health care, from whom and whether the proposed treatment is followed. In some countries more than 50% of medicines consumed (including prescription drugs) are bought over the counter, often from unauthorized sources, and often in response to aggressive commercial marketing.

This session will focus on the need for public education on the use of medicines, how to develop and implement a relevant strategy, and discuss possible constraints. It will also review some of the initiatives currently taking place in different parts of the world and discuss principles of effective public education.

OBJECTIVES

To develop your ability to:

1. Understand the role of public knowledge, attitudes and practice in the use of medicines2. Identify the major drug utilization problems in your community3. Identify the components of a comprehensive public education program for rational drug use4. Identify the various channels that exist in the community to convey consumer education

PREPARATION

1. Study the module Principles of Face to Face Education.

2. Read Chapter 33 of Managing Drug Supply 2nd edition.

FURTHER READING

A substantial list of further readings and resource materials can be found in Annex One.

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Effective Public Education

SESSION NOTES

In emphasizing the prescriber's role in promoting rational drug use, it is easy to lose track of the importance of the patient. To do so is a serious mistake. The knowledge, attitudes, and education of the general public are crucial determinants in the decision to seek health care, the choice of provider, the use of medicines, and the success of treatment.

A. THE PATIENT'S ROLE

Patients are actively involved in the therapeutic encounter and in treatment. In the final analysis, it is the patient who will decide whether to go ahead with a treatment or not. Patients go through a series of decisions before a treatment is self-chosen or prescribed.

First: People who are ill have to believe that there is "something wrong" with their health. This perception is to some extent culturally defined.

Second: People have to decide whether this problem is significant enough to make them seek help, or if the symptoms will go away without treatment.

Third: Once they have decided that help is needed, people choose where to seek help: this may be at a hospital, a primary health care center, a private physician, a pharmacist, a market vendor, a traditional healer, a relative or other member of the community. They may decide -- although this assessment may not be accurate -- that the symptoms are sufficiently minor or that they are familiar enough with the required treatment to directly self-medicate either with a modern pharmaceutical or a traditional remedy.

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(Figure 1)

Community drug distribution channels: an example from the Philippines. Source: Hardon A. Confronting ill health: medicines, self-care the and poor in Manila, HAIN, Huezon City 1991.

This figure is based on weekly interviews on health problems and treatment practices during a five-month period with 126 families in two urban slums in Metro Manila. The arrows illustrate the relative importance of the various routes that pharmaceuticals follow before reaching users. In this example the health centers only account for a fraction of drug supply. The majority of drugs are purchased in neighborhood stores and/or in pharmacies, together accounting for around 80% of total drug purchases.

Think about the situation in your own country:Where do sick people go for help? Where do they obtain their medicines? See the example from the Philippines (Figure1).

Fourth: Once they have a prescription, patients decide whether to buy the drugs or not; whether they are going to buy all the items recommended in the prescription, or only some of them; and which drugs to buy. In doing so they may need to decide what items are important and worth buying.

Fifth: Patients decide whether and when to take the medicines; whether to continue taking

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them, if side effects occur or if their symptoms disappear, and what to do with any medicines that remain unused.

B. CONCEPTS OF DISEASE ETIOLOGY

If we ask a physician what causes a certain disease -- diarrhea for example -- the answer could be "eating food contaminated with bacteria or virus which produces toxins that lead to a disturbance in the electrolyte absorption at the small intestine." Yet, if we ask an illiterate villager the same question, the answer could be: "Evil eye leads to weakening resistance and enables spirits to hurt the patient."

Before any attempts are made to design a health education program, it is important to understand the popular concepts of disease etiology in the community. For example, a study in Jamaica revealed that most illnesses are believed to be caused by (1) "cold," (2) "gas" or "wind," (3) "heat," (4) "bile," (5) "blood imbalances," and (6) "germs." Etiological explanations involving heat, cold, bile, and gas/wind are applied mainly to symptoms in which there is a feeling of pain, heat, or chill, or where there is discharge. Those involving imbalances of blood are applied to internal conditions and changes in the skin; those involving germs are applied primarily, but not exclusively, to venereal diseases.

In Java, as another example, many mothers perceive diarrhea as a normal consequence of physiological growth of the child. This often led them to underestimate the condition before it becomes more serious.

What are some popular concepts of disease etiology in your country?

C. CONCEPTS OF CURE

A commonly held belief is that "symptoms" are equal to "disease." Therefore, if there are no symptoms it is assumed that a person is well. When symptoms are present, they are the diseases itself. For example, a skin lesion, caused by diabetes, is considered the disease itself. By this reasoning diabetes is considered cured if the lesion goes away. This may explain why it is sometimes difficult to convince diabetic or hypertensive patients to continue taking their medicine even after the symptoms have disappeared.

D. CONCEPTS ABOUT THE THERAPEUTIC VALUE OF DRUGS

Some patients may value drugs according to:

• Mode of administration• Packaging• Rapid/slow action• Cost• Taste• Color• Source (prescriber)

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Generally, a medicine that quells a symptom is considered "good," and one which does not, is considered ineffective. This may explain why some patients, and even physicians, are reluctant to use ORS for childhood diarrhea; the symptoms do not immediately disappear after its use. Often, patients demand or prescribers prescribe more drugs for acute diarrhea, since ORS is not considered as a drug (not stopping the diarrhea).

E. EFFECT OF PROMOTION AND MARKETING ON THE USE OF DRUGS

Drug promotion is playing an increasingly important role in shaping utilization patterns. With over 50% of all medicines bought directly by the consumer, direct promotion of OTC drugs to the consumer is common in almost all countries of world. In a few countries, the United States for example, direct advertising of prescription drugs is permitted. In areas where legislative and regulatory control of pharmaceutical promotion is weak - the case in most developing countries. Uncontrolled advertising may be misleading and can contribute to inappropriate drug use with major financial and public health implications for the individual and the community. One study in Yogyakarta, Indonesia, showed that most consumers do not know the active ingredient of the most commonly used commercial products. They often relate the indication only with trade-names, due to misleading advertisements. This may lead to the use of different commercial products with the same active compounds at the same time. Or, certain products may be used for the wrong indication, e.g.: paracetamol for symptoms of weakness.

Think about the methods of drug promotion that exist in your country:• How accurate is the information presented?• What are the most frequent types of drugs advertised?• What is the effect on drug utilization?

See Annex Two for some examples.

F. SOCIAL MARKETING

Traditionally, health education has been of low priority in national public health strategies. One reason for this lack of support is that it has been seen as a soft subject, lacking the intellectual rigor of other more quantifiable scientific disciplines. Another reason is probably the traditional medical model, which holds the patient to be a passive recipient, rather than an equal partner a health care interaction. Until recently, also health education (as traditionally practiced) has often suffered from a lack of comprehensive planning. Health educators have too often pushed down messages, in inappropriate language through weak communication channels, and failed to reach or impact on the target audience.

Health education materials often failed to take into account that all human behavior is integrated into a cohesive cultural context. What may seem irrational in terms of Western scientific understanding may often be perfectly rational in terms of an individual's culture and framework of reality.

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Starting in the 1970s, a number of developments broadened our view of how health education could and should be practiced. In 1978 in Alma Ata, WHO initiated a fundamental change in public health thinking, moving from an emphasis on disease eradication to one stressing prevention and the needs of the rural poor and social equity. This strategy centered on the core empowerment of the community through education and participation in decision-making.

Health educators and communicators began to look for workable and proven strategies that would enable public health communication to take place within a comprehensive and viable framework. One area was commercial marketing practice, since it was obvious that such marketing must be successful in influencing behavior. Companies would not spend billions of dollars a year in advertising and promotion if it were not worthwhile. In the field of drugs, for example, promotional budgets can be as much as 20% of the turnover. This led to using the techniques of commercial marketing to promote social ideals.

Social marketing models, first articulated by Philip Kotler and based on commercial marketing practices, show that the consumer (target audience) should be the central focus for planning and conducting a program. The program's components focus on what is known as the 4 Ps.

Price: what the consumer must give up in order to receive the program's benefits. These costs may be intangible (e.g. changes in beliefs or habits) or tangible (e.g., money, time or travel).

Product: what the program is trying to change in the target audience. Promotion: how the exchange is communicated, e.g. appeals used. Place: what channels are used to reach the target audience (e.g. mass media,

community, interpersonal).

The formulation of price, product, promotion and place, have to be determined on the basis of research with the consumer to decide what benefits and "costs" they would consider acceptable, and how they might be reached.

Lessons learned from social marketing stress the importance of understanding the target audience and designing strategies based on their perceptions, wants, and needs.

However, it must be recognised that most social marketing campaigns, particularly those sponsored by international development agencies, have as their start a given product or behaviour to be promoted. They then use research into local social norms and culture to determine how best to “market” their “product” which may be a contraceptive or an immunization campaign, for example. For this reason, social marketing is sometimes criticized as not being truly participatory.

Another psychosocial model which has been developed to identify what people believe and why they believe it is the Health Belief Model, which explains health behavior through expectancies. Used as a tool for analyzing health-related behavior, its key variables are:

Perceived susceptibility: this refers to an individual or group's subjective perception of the risk of contracting a health condition and susceptibility to illness in general.

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Perceived severity: this refers to feelings about the seriousness of contracting an illness or of leaving an illness untreated. It includes perception of the medical and clinical consequences (death, disability, pain) and social consequences (effects on work, family life, social relations).

The above two categories can be combined into a perceived threat.

Perceived benefits: these depend on beliefs regarding the effectiveness of various actions in reducing the disease threat, or the perceived benefits of taking certain health actions.

Perceived barriers: the potential negative aspects of a particular health action (the perceived barriers) may act as impediments to undertaking the recommended behavior. Individuals may unconsciously weigh an action's effectiveness against perceptions of expense, danger, unpleasantness, inconvenience/disruption, or time-consumption.

Self-efficacy: this is the conviction that one can successfully execute the behavior required to produce the outcomes, often over a prolonged period.

Reviews of this model in the last 10 years found that it is valid for explaining many health behaviors. Perceived barriers were found to be the most powerful single predictor of behavior, and perceived severity the least powerful predictor. These and other behavioral theories are very helpful when developing communication strategies. They have at their core the fact that behavior modification is based on a complex web and analysis of personal and societal factors which must be investigated and taken into account in the communication strategy. This process is very far removed from the classical health educator's job, deciding on a slogan, and commissioning a graphic to be reproduced in 10,000 posters. It focuses on where the consumer is coming from; not the educator.

G. GLOBAL PUBLIC EDUCATION INITIATIVES RELATED TO DRUG USE

Until recently, national health education focussing on the proper use of medicines was rare in both developed and developing countries, although some consumer organizations have conducted campaigns, usually against unethical marketing of individual drugs. However, escalating cost of medicines, the wasted resources resulting from their misuse, the increasing amount of self-medication, and the influence of advertising, has led to a new focus on the role of and the need for an informed consumer. This is particularly true in countries with a diminishing budget for public sector drug supply. This led to the development of national public education strategies. Another factor has been the growing awareness that a patient/prescriber encounter is an interactive process in which each can influence the other. Some prescribers excuse bad prescribing practice by claiming that patients insist on receiving a certain drug (e.g., an antibiotic) or mode of delivery (e.g., an injection) and will go elsewhere if do not get it.

Increasingly, consumer organizations are at the forefront of consumer education activities and campaigns. Members of the consumer network Health Action International, which includes over 100 public interest non-governmental organisations throughout the world, have recently held

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campaigns targeting the removal of dangerous drugs from the market, unethical promotional practices, the need for national drug policies and effective regulation.

There are a number of ways or channels in the community to convey education and share information, for instance through women's organisations, social gatherings, religious leaders/groups, at the outpatient unit or health care staff, performances of drama, song, etc. In Indonesia, a training module on over-the-counter (OTC) drugs has been field tested and disseminated through community women's organizations with a self-active learning process utilizing drug package inserts. The activity is carried out in small groups and has proved to be effective in improving the appropriate use of OTC- medications.

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H. DEVELOPING A PUBLIC EDUCATION STRATEGY

Public education cannot compensate for poor products or inadequate health services or staff. However, it can provide the consumer with a better understanding of the benefits and the potential dangers of drug use, and safe sources of drug information and supply. An informed and empowered consumer is able to act in his or her own and in the community's best interests.

Changing people's behavior or habits is not an easy task and generally requires a long term strategy based on the behavioral principles outlined under F. A behavioral modification intervention has to be undertaken with knowledge of the social and cultural context in which it is based.

1997 Kumarian Press excerpted from Managing Drug supply, Management Sciences for Health and WHO.

The process

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EFFECTIVE PUBLIC EDUCATION SESSION GUIDE Effective Communication involves a number of steps (see Figure 2). It is essentially a process; one that continually evolves and is modified as monitoring takes place.

STEP ONE: INVESTIGATE

The investigatory stage is essential and at the core of the communication process. It should address the following issues:

1. What is already known about the problem?

In the case of drug use, studies may already have been carried out (e.g. reports from health workers, NGOs, prescribing data) indicating problems such as heavy commercial marketing of irrational or dangerous drugs. Which related activities, such as EPI or ORS campaigns, have taken place? What organizations (e.g., UNICEF, NGOs, and national AIDS programs) have undertaken public educational activities in health areas?

2. What new kinds of information are needed?

* What are the characteristics of the target audience?- demographic characteristics- socio-economic status- individual literacy and household literacy rates- language patterns - community decision and leadership process- sources of drugs- health services usage patterns- characteristics of prescribers and users: knowledge, attitude and practices

* What communication networks are there?- What sources of information about drugs are most credible to the target

audience? To whom do they speak and listen? And for what types of information?

- What channels of information reach users most effectively, including mass media?

* What development communication resources are there?- research- education/training- production and distribution of information - social mobilization

3. How should these data be generated?A combination of qualitative and quantitative research methods can be used.

Quantitative methods, such as household surveys, provide useful information on levels of knowledge and on the practice and beliefs prevalent in a given population. They measure what is happening. These methods are most useful as pre- and post-intervention evaluation tools.

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Qualitative methods, such as focus group discussions, and in depth individual interviews, yield substantial information about specific behaviors, as well as the reasons and motivations underlying them. They measure how and why things are happening. The focus group is a research method borrowed from commercial marketing. Focus groups are very useful in opening people up to talk more freely, particularly about sensitive subjects. They generate a lot of ideas, and provide language to use in communication materials.

STEP TWO: PLAN COMMUNICATION ACTIVITIES The communication plan provides the road map for communication activities. When it is first written it is quite broad. Its primary purpose is to establish clear and feasible objectives and to outline how they are to be reached. However, the communication plan should be adjusted or revised over time as more information on the audience is obtained through research, pre-testing of communication materials and monitoring.

A communication plan should include:

- Target audience- List of behaviors to be adopted/changed- Constraints- Facilitating factors- Communication objectives- Approaches to change: power/sanctions, logic/facts, appeal/emotion,

incentive/reward, facilitation/remove obstacles, fear or danger/emotion - Communication channels to be used to deliver the messages- Media mix: in general a communications program should use a combination of

channels to maximize exchange.

Possibilities include:

- audio-visual aids: posters, flyers, pamphlets, brochuresmass media: radio, television, newspapersinterpersonal (or face-to-face): this includes the use of well-informed or trained agents at the community level, such as health workers, school teachers, community leaders, shopkeepers, community organizations

- Collaborating institutions: collaborating with a wide range of institutions in communication activities enhances visibility, potentially increases impact and acts as general advocacy for rational use concepts and the national drug policy.

- Monitoring and evaluation.

The communication plan should include a timetable and a budget, plus the source of financing. It can be very difficult to stick to both. So, overestimate rather than underestimate.

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EFFECTIVE PUBLIC EDUCATION SESSION GUIDE Approval of the plan will be needed, and this may entail government ministries, such as health, education or information; broadcasting authorities, and a formal commitment from participating

NGOs. Getting the plan formally approved by key authorities helps elicit their commitment and minimizes any possible confusion about objectives and implementation once, implementation has begun.

STEP THREE: DEVELOP COMMUNICATION MATERIALSFormative research should provide the data needed to decide on approaches, communication channels, and the messages to be conveyed. It should also provide indications of the language and expressions being used.

STEP FOUR: TEST AND REVISE MATERIALSThe materials and products are tested on representatives of the target audience to ensure that they are understandable, appropriate and attractive.

Testing should answer the following questions:

- Does the target audience understand the materials?- Do they feel that the materials apply to them or to other people?- Is there anything offensive or culturally inappropriate?- Based on responses from the audience do the messages or their format have to be

changed?

Pre-testing the materials is essential and will often produce surprising results. A picture may be completely misunderstood, particularly if it uses a stylised design convention in a society relatively inexperienced in graphic images. For example, an ORS poster in Honduras initially showed a sequence of four boxes showing the correct sequence for mixing. The sequential numbers included in each box were interpreted by the target audience to mean that one cup of water was to be added to the packet, two corners torn off, three packets emptied into the bottle and the bottle shaken four times. See module on Printed materials.

STEP FIVE: IMPLEMENTATION AND MONITORING

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EFFECTIVE PUBLIC EDUCATION SESSION GUIDE When implementing a public education campaign, it is important that all the resources both human and material are fully prepared. This may mean stockpiling posters, pamphlets video

materials, booking venues and arranging for staff to be available well in advance. Monitoring is essential to ensure that all is going to plan and that there are no hold-ups or other problems.

Monitoring:- Are the target audiences receiving and in contact with the program materials and

messages?- Are they using the materials and learning from the program messages?- Is the program on schedule? If not why not?- Will program delays have implications for other activities?

As the program progresses it may be necessary to modify the original plan on the basis of monitoring indicators.

STEP SIX: EVALUATE AND REVISE

Evaluation:

- Were the program objectives met? Pre- and post-intervention quantitative research will help measuring the impact.

Evaluation is also critical but often neglected. It is the only way to determine the impact of your work and whether the approach has been effective. A recent public education study by the WHO Action Programme on Essential Drugs found that evaluation was the exception rather than the rule and that even where programmes reported doing evaluations these were rarely available in documented form.

Feedback:

* Why did the program work or not?* Are there program changes or improvements that may increase the its success?* Are there lessons to be learned that would help to make future programs successful?

It is important to fully document communication activities not only to facilitate proper monitoring and evaluation, but also to ensure that people planning future communication program can learn from your experience. It is often very difficult in developing countries to find reports of even large the scale communication activities. This leads to unnecessary "reinventing the wheel" and waste of experience and resources.

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ACTIVITY ONE

Designing a Public Education Program

RATIONALE

This activity will help you to apply a systematic planning approach to designing a public health education project aimed at tackling a drug utilization problem in your program.

Instructions

1. Divide into small groups.

2. Using the attached Worksheet #1.1, identify a common drug utilization problem in your community; answer the questions included which will help you to develop a strategy, test it for implementation, and evaluate its impact.

3. Work on the details of how you will deliver the message. For example, you might choose one of the following interventions:

• patient education in hospital outpatient departments• training of mother's groups• community education via religious organizations• mass media campaign

4. If time permits, work on aspects of pre-testing, financing, monitoring and evaluation.

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WORKSHEET #1.1Designing a Public Education Program

PROBLEM

1. State the drug utilization problem.

AUDIENCE

2. Who is the target population?

3. What additional information would you like to have about the target population?

4. How will you obtain this information? (Briefly describe methodology and identify institution/department that can undertake this work).

5. What are the potential channels of communication? (e.g., TV, radio, women’s groups, traditional theatre, printed materials)

6. Which channels of communication would have the most impact and why? (e.g., cost-effective, appropriate, influential, media reach, etc.)

INTERVENTION

7. What is the overall goal and what are specific objectives of the education campaign? (If possible, place them also within a broader national context, e.g., national drug policy.)

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8. What constraints do you expect to face (put in order of importance)?

9. What facilitating factors do you count on (put in order of importance)?

10. What is the specific message that you would like to deliver to the public?

11. What methods are you going to use to deliver the message?

12. How will you pre-test materials and with whom?

13. What will be the timeframe for activities?

FINANCING

14. Who will finance the activity? List potential sources of financing, such as government, NGOs, or international organizations.

15. What potential collaborating partners exist?

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Monitoring and evaluation

16. How are you going to monitor implementation and evaluate the impact of your program?

17. How will you share information to build on what has been accomplished?

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ANNEX ONE

Further Readings and Resource Materials

Planning information, education, and communication programs

US Department of Health and Human Services. Making Health Communication Programs Work: A Planner's Guide, NH Publication No. 89-1493, Washington, 1989.

World Health Organization, Diarrhoeal Diseases Control Programme. Communication: a Guide for Managers of National Diarrhoeal Disease Control Programs, Geneva, 1987.

Zimmerman M., Newton N., Rumin L. and Wittet S. Developing Health and Family Planning Print Materials for Low-Literate Audiences: a Guide. Program for Appropriate Technology in Health, Washington, 1989.

Rasmuson, M.R., Seidel, R.E., Smith, W.A., and Booth, E.KM. Communication for Child Survival. HEALTHCOM. Project conducted by the Academy for Educational Development for USAID, Washington, D.C, 1988.

Seidel R. Results and Realities: a Decade of Experience in Communication for Child Survival. HEALTHCOM. Washington, D.C., 1992.

Pan American Health Organization/WHO Regional Office for the Americas. Making Health Communication Programs work in Latin America and the Caribbean: a Manual for Action, Washington D.C.m 1991.

Kotler, P. and Andreason A.R. Strategic Marketing for Nonprofit Organizations: 3 ed. Prentice-Hall, Englewood Cliffs, 1987.

Suryawati S. Practical Guideline: Improving the Knowledge and Skills in Selecting Medicine Using CBIA Method. An intervention educational module for improving the quality of self-medication. Department of Clinical Pharmacology, Faculty of Medicine Gadjah Mada University, Yogyakarta, 1993.

IEC Research methodology

World Health Organization, Action Programme on Essential Drugs. How to investigate Drug Use in Communities, WHO/DAP/92.3, 1992.

Debus M. Handbook for Excellence in Focus Group Research. Academy for Educational Development, Washington D.C., 1990.

Drug promotion and marketing

World Health Organization. Ethical Criteria for Drug Marketing and Promotion, Geneva, 1988.

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EFFECTIVE PUBLIC EDUCATION SESSION GUIDE Health Action International. Promoting Health or Pushing Drugs? HAI, Amsterdam, 1992.

Chetley, A. and Gilbert D. Problem Drugs. Health Action International, Amsterdam, 1993.

Studies of community knowledge, attitude and practice regarding the use of medicine

Hardon A. Confronting Ill-health: Medicines, Self-care and the Poor in Manila, HAIN, Quezon City, 1991.

van der Geest S. Self-care and the informal Sale of Drugs in South Cameroon. Soc.Sci.Med. Vol.25, No.3, pp.293-305, 1987.

van der Geest S., Hardon A., Whyte, S.R. Planning for essential drugs: are we missing the cultural dimension? Health Policy and Planning: 5(2): 182-185. Donovan J. L. and Blake D.R. Patient Non-compliance: Deviance or Reasoned Decision-making? Soc.Sci.Med. Vol.34, No.5, pp.507-513, 1992. Sachs L. and Tomson G. Medicines and Culture - a double Perspective on Drug Utilization in a Developing Country. Soc.Sci.Med.Vol.34 no.3, pp.307-315, 1992.

Wolf-Gould C.S., Taylor N., McCue Horwotz S. and Barry M. Misinformation about Medications in Rural Ghana. Soc.Sci.Med.Vol.33 No.1, pp.83-89 1991.

National publication education campaigns on rational drug use

Australia: Campaigns on Drug Use and the Elderly; the Wise Use of Medicines; and a school education kit, using videos, TV spots, brochures and posters. For further information contact: Ms L. Coper, National Director, Australian Pharmacy Self Care Programme, National Secretariat, P.O. Box 2l, Curtin ACT 2605, Australia

France: Campaign for wise drug use : don't take drugs lightly (Campagne bon usage du médicament : un médicament ca ne prend pas à la legere); posters, leaflets and TV spots (in French). For further information contact: Ministère des Affaires Sociales et de la Solidarité, 100 avenue Raymond Poincaré, 75116, Paris, France

USA: Medicine: before you take it talk about it campaign. Posters, leaflets, radio spots, information folders, activity sheets. Annual newsletter for "Talk about Prescriptions month". For further information contact: Mr R. Bachman, Executive Director, National Council on Patient Information and Education, 666 Eleventh Street, N.W., Suite 810, Washington, D.C. 20001, USA

Bolivia: Posters, leaflets and radio programs (in Spanish). For further information contact either the WHO Action Programme on Essential Drugs, Geneva, Switzerland or the Bolivian Essential Drugs Programme c/o WHO Representative, La Paz.

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EFFECTIVE PUBLIC EDUCATION SESSION GUIDE Philippines: Posters, leaflets and TV spots. For further information contact Dr Quintin L. Kintanar, Head, National Drug Policy Office, Director, Bureau of Food and Drugs, Alabang, Muntinglupa, Metro Manila, Philippines

Copies of National IEC strategy plans that can be used as examples in developing programme activities are available from the WHO Action Programme on Essential Drugs.

Internet resources:

View locally or access on the web at http://www.who.int/dap-icium/posters/3B2_TXTF.html View locally or access on the web at http://www.who.int/dap-icium/posters/3B1_TXTF.htmlView locally or access on the web at http://www.who.int/dap-icium/posters/3B3_TXTF.htmlView locally or access on the web at http://www.who.int/dap-icium/posters/3C4_TXTF.htmlView locally or access on the web at http://www.who.int/dap-icium/posters/3F3_TXTF.htmlView locally or access on the web at http://www.who.int/dap-icium/posters/3A2_TEXT.htmlEssential Drugs Monitor http://www.who.ch/programes/dap/edm/edm18a.html

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http://www.who.ch/programes/dap/edm/edm18a.thml

http://www.who.int/dap-icium/posters/3A2_TEXT.html

http://www.who.int/dap-icium/posters/3F3_TXTF.html

http://www.who.int/dap-icium/posters/3C4_TXTF.html

http://www.who.int/dap-icium/posters/3B3_TXTF.html



EFFECTIVE PUBLIC EDUCATION SESSION GUIDE ANNEX TWO

Public Education Campaigns on Drug Use

Australia: public education work has centered around the role of the community pharmacist as a reliable source of information about medicines; on the need for adequate communication between the health professional and the client about prescribed medicines; about polypharmacy of the elderly and actions that older citizens can take to monitor drug use. A school education pack has also been developed and widely disseminated. Materials include videos, TV spots, and educational leaflets and posters. Philippines an active public information campaign has explained the rationale of the National Drugs Policy through a widely distributed booklet, t-shirts, TV spots and posters. The campaign has also highlighted consumer rights, showing what should appear on a properly written prescription, explaining the difference between a generic and a brand name drug, and promoting the individual's right to purchase a cheaper equivalent product.

Malawi: after initial community research, the Government has adopted a comprehensive strategy of public education on the rational use of drugs within the context of the national drugs policy and essential drugs programme. This encompasses education for primary school children in medicine use, and the use of a variety of media such as traditional theater, the literacy programme, the mass media, and graphic materials to disseminate rational use messages. The campaign will also use interpersonal communication through educational sessions on drug use in health centers, and training in communication techniques between prescriber/dispense and patient, explaining both responsibilities and rights to information.

Myanmar: after conducting formative research, the Myanmar Essential Drugs Programme is implementing a public information campaign on the programme and the proper use of medicines using the mass media and printed materials.

Bolivia: education activities have included an illustrated brochure explaining the essential drugs concept and its contribution to health, safety and saving costs for the community, backed up by posters on the same theme, and the broadcasting of more than 50 short radio programs discussing various aspects of drug use and treatment of common ailments.

USA: a campaign which has been conducted over more than a decade by the National Council on Patient Education includes radio spots, resource packs for health professionals, companies, community groups and individuals. Each year activities are intensified in a monthly campaign for which additional materials are produced on various problems/solutions related to the use of medicines. The leitmotif of the campaign has been the need for good communication between prescriber and patient with materials targeted to both groups. In 1989 the campaign focused on the special drug use problems of the elderly.

France: an ongoing campaign urges French consumers not to "take drugs lightly" and includes TV spots, posters, leaflets for pharmacies and press articles.

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